Running Injury and Minimalist Shoes

Our clinic sees lots of running injuries. Plantar fasciitis, shin splints, ankle pain, foot pain, calf strains, IT band syndrome, patellofemoral syndrome…the list goes on and on. These injuries are relatively common among runners and there are many different causes. Given that many of these injuries are related to impact, for some people, the finger could be pointed at minimalist shoes.

As a healthcare practitioner, my primary concern is keeping my patients healthy, allowing them to continue running for a long time. Strictly speaking from an injury risk perspective, I would think that minimalist shoes would not be a great idea, especially considering the role that impact plays in many running related injuries. Instead of giving my professional opinion though, let’s look to the published literature on the topic! An interesting study published in 2013 investigated bone marrow edema in the feet of experienced runners before and after ten weeks of running in minimalist footwear. The findings showed no injury to the soft tissues but 10 of 19 subjects showed increases in bone marrow edema on MRI in at least one bone after 10 weeks of training (when compared to the control group).

Although none of the subjects experienced soft tissue injuries, it’s possible that the training protocol wasn’t long enough. I’m sure many people would agree that 10 weeks is a relatively short amount of time for most runners. Perhaps after 10 weeks, injuries occur. With respect to the bone marrow edema, I would say that the findings are “interesting”. At this point, given the literature that exists on the topic, I wouldn’t tell any of my patients to rush out and buy these shoes, but I also wouldn’t be so quick to criticize them. If you do choose to run in minimalist shoes, here is the recommended method (from a manufacturer) for transitioning to these shoes. Keep in mind, these recommendations are being made from a manufacturer and are likely not substantiated by good peer reviewed literature.